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31 Jan 2007 : Column 86WH—continued
I have held two large public meetings and would like to answer some of the questions that have been raised by colleagues. My right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith) raised the question: what about all the new people coming in from the Thames Gateway? I asked that question of the health services at a public meeting a
few weeks ago and was told that the homes being built are obviously for young people, and young people will not be ill or need hospitals. I shall be recommending that anyone who wants to guarantee that they will never be ill should move to our area. It is guaranteed: the health authorities say that they will not be ill if they live in Redbridge. That is lunacy, and unless I am much mistaken, young people get older.
Mr. Duncan Smith: And they have accidents.
Mr. Scott: No, I am sorry. Having accidents is not allowed.
Hundreds of people have attended the public meetings that I have been holding, and there are thousands of signatures on a petition that I shall present early in the coming month. At a meeting chaired by the editor of the Ilford Recorder I asked the head of the primary care trust the reason for the proposals and she said that if she did not do it they would sack her and get someone who would. Those were her words, not mine.
I do not want option 1, option 2, option 3 or option 4. I do not want any of the options. The people of Waltham Forest, Barking and Dagenham, Redbridge, Havering and Epping Forest deserve better, and there should be no cuts to any of the services. I agree with the hon. Member for Walthamstow (Mr. Gerrard) that no one is saying that there should not be change or improvement. Of course there should; things should evolve. What we are talking about is not change. The new Queen’s hospital, as a matter of interest, has fewer beds than the old Oldchurch and Harold Wood hospitals that it has replaced, so I am not sure how it will cope with input from Redbridge or Waltham Forest.
I live midway in my constituency and I travelled—not in the rush hour—by car to Queen’s hospital, to see how long it would take. It took me 35 minutes, outside traffic, from my home. Some people are without the use of a car, and need to use three or four buses to get there. People will die. That is not over-dramatic or over-emphatic. People will lose their lives if they have to go to the new Queen’s hospital. The Minister may want to hear—he will not hear it often—that I congratulate the Government on Queen’s hospital, which is wonderful for the people of Romford. However, it will not help my constituents one iota. Taking away our services will not help us.
I want to describe some issues that have arisen during the period of this proposal. No one really wants our input. I have been invited to various meetings and because both hospitals affect my area I have been to meetings with both trusts. Some of them have not involved colleagues; I have been invited on my own to meetings where I have not learned anything different from what other hon. Members have been told, but there has been an attempt to get my support for something that I cannot support in any way. I have made it clear that I will campaign with my colleagues to stop the cuts.
A few weeks ago a reporter took more than 1 hour and 10 minutes to get by bus from the constituency of the hon. Member for Ilford, South (Mike Gapes) to Queen’s hospital. It would have taken even longer by bus from my constituency, because I am a bit further
away. We are at a stage in the procedure at which consultation has been pushed further and further back. To echo what we heard earlier, at my last public meeting various heads of different bodies involved with health care provision were asked whether they had been consulted. Every one said no—nothing, not a word. An apology was given for that; it is said that they will be consulted after the final option has gone forward. I think perhaps if we are truly going to consult we should do it in all communities, at the start.
We are sending out a message loud and clear today. Because of time and because of other hon. Members wishing to speak, I shall not go over points that have already been covered, but I want to send a final message, which is, I hope, from us all: we are not going to stand for it. It is not on. All our constituents deserve better. I plead with the Minister to think long and hard before any proposals are put into practice and to consider all the wider issues.
We have heard about the Olympics and pressure on neighbouring hospitals that cannot cope. Before Christmas certain treatment provisions were transferred from the King George to Queen’s hospital. The Minister may be interested to know that they have been transferred back, because Queen’s hospital could not cope. How will it cope with the present proposals?
10.19 am
Mike Gapes (Ilford, South) (Lab/Co-op): It is a real pleasure to follow my friends who have made speeches or interventions. We are all on the same side in this debate. I am the Member of Parliament for the constituency with the hospital that will be decimated under the preferred option of those under consideration—option 4. King George hospital is not an old hospital; it is a new hospital in health service terms. It was built in 1993. I was at the official opening of the hospital by the then mayor of the London borough of Redbridge, my friend, former constituency neighbour and predecessor to my friend the hon. Member for Ilford, North (Mr. Scott), Linda Perham. The hospital serves a community and it is incredibly busy. There was a period when it had on average 97 to 98 per cent. bed occupancy. More than half its admissions were to its accident and emergency department, and the hospital has had to put on two so-called temporary wards for some years, because it has not been big enough to cope with the pressure.
About 10 years ago, the acute trusts in north-east London were reorganised, and Barking, Havering and Redbridge were put together. At that time, the then Secretary of State for Health, the right hon. Member for Holborn and St. Pancras (Frank Dobson) assured me that there was no threat to the hospital or to its accident and emergency department as a result of the reorganisation. I believed that promise: I persuaded local trade unionists at a meeting that there was no hidden agenda, and I also attended a public meeting with the then chief executive of the new trust.
On the basis of that assurance, the bureaucrats working on the north-east London proposals are, by subterfuge, undermining the promise made to me by a former Secretary of State for Health, and they are already transferring from King George hospital to Queen’s hospital. Queen’s hospital is a fantastic new building. Some of my constituents think that it looks
more like an hotel or an airport than a hospital; nevertheless, they regard it as a fantastic building. However, other constituents have written to me about problems with it. One constituent said:
“I have had the unfortunate experience of having to attend the new Queen’s hospital for an outpatients appointment. When you walk through the doors you are confronted with an enormous almost empty open space with a few shops etc either side and, believe it or not, a grand piano!! Wow that immediately made me feel well again!
I was directed to the outpatients waiting room, a room no larger than my lounge, where all outpatients wait. When a hospital porter tries to get through with a wheelchair or trolley everyone waiting in the queue to book in with one of the two or three receptionists, has to try to disperse to make space. If it wasn’t so pathetic it would be laughable... They have concentrated on design without giving any thought to suitability.”
I received that e-mail from a constituent only yesterday.
I have a fax of a letter that was sent three weeks ago:
“I am Polio Disabled and use a wheelchair. I regularly go to King George’s for check-ups for Breast Cancer and I have had occasion to use Gynaecology and Orthopaedic departments as well as the A and E department. Whereas I can be wheeled to King George for appointments or treatment, I would have to use the car to go to Queen’s and car parking space is at a premium. To go to Whipps Cross does not bear thinking about.”
And I also received the following correspondence:
“Alice is very old and fading fast in KGH, where her care has been excellent. If she was in Whipps X or Queens, she would have had no visitors.”
I said during the Christmas Adjournment debate on 19 December that the problem is the bureaucrats. They have a mindset driven by accountancy and by models of health care that take no account of the poorest people in the poorest communities. Forty per cent. of my constituents in the Loxford, Valentines and Clementswood wards do not have access to a car. My constituency has a large and growing ethnic minority population. It includes refugees and people from the Indian subcontinent, many of whom have young children and do not drive cars. If the accident and emergency department closes at King George hospital, they will expect to go, as the Ilford Recorder reporter did, by two or three buses to get to Romford.
The original proposals in “Fit for the Future” said that it was “addressing health inequalities”. As I told the House on 19 December, it does address them: it makes them worse. The proposals are designed to penalise the poorest and the weakest in the interests of a financially driven model that takes no account of local needs or wishes.
I am not confident that the upcoming consultation exercise has any significance or meaning. The hon. Gentleman referred to Barratt Homes and planning issues. He knows, because it was confirmed at the meeting in December, that North East London Mental Health Trust has had plans for some time to rebuild facilities on the Goodmayes hospital site, which is next to King George hospital. Goodmayes is a 19th-century mental health institution that has been significantly changed over the years. It now has state-of-the-art private finance initiative facilities, but the trust wanted to build new blocks next to it. Those plans, which I was told about a year and a half ago, have been put on hold
because the trust now plans to switch facilities to the King George hospital site in buildings that will be vacated by getting rid of elective work and by closing down the accident and emergency department. It is an economic measure, and I want to know about the trust’s long-term plans.
I understand that the Maskells Park site, which is part of the mental health trust will be closed. The trust was going to transfer the work to the Oldchurch hospital site that was vacated as a result of building the new Queen’s hospital. Now, the suggestion in train is that the trust will use the Goodmayes site and concentrate mental health facilities there. It will be able to do so in King George hospital buildings—instead of using them for accident and emergency work to serve my constituents and those of my friend the hon. Member for Ilford, North. I ask questions now, because we were not given that information. There is stuff going on in the health economy, and we are not being given the full facts.
Mr. Scott: At the last public meeting, the trust admitted that and denied it in the same meeting, so the hon. Gentleman’s guess is as good as mine.
Mike Gapes: The basis of the exercise is rigged. Reference was made to patient flows. We have just been sent documents by Finnemore Consultants, which is like a company doctor: it closes down departments and hospitals throughout the country. It has included its CV, which shows that it has been involved in Derbyshire, in the west of England and in various other places. It is as though Finnemore is proud of its work; however, it should not be proud of what it proposes in my constituency.
Interestingly, the documents include data about patient flows out of the north-east London health economy. The reason why option 4 is favoured is that because under it, only 7,000 operations will have to be carried out outside the area; whereas under option 2, it is 11,000, under option 3, it is 22,000 and under option 5, it is 26,000. The proposals are not about patient need; they are about stopping patients leaving the local health economy, so that primary care trusts in Barking, Havering, Redbridge, Dagenham and Waltham Forest keep their patients in the local economy.
I wrote to Ruth Carnall, chief executive of NHS London, the day after my speech on 19 December. I sent her a copy of it on 20 December. I received a reply yesterday, dated 22 January, saying that she is not prepared to stop the process, pending Professor Ara Darzi’s London-wide review, because:
“My letter to MPs dated 4 December explained why, as well as commissioning a London-wide review of strategy, we thought it important to continue with some local reconfigurations where there was an urgent clinical and financial case, and where the emerging direction was consistent with national policy.
In North East London the proposals that are being developed are consistent with the policy of shifting care from acute hospitals to community and primary care settings, and concentrating specialist expertise.”
There is nothing there about the needs of patients. It is all about the needs of a model that cannot work unless the investments in primary care referred to by my hon. Friend the Member for Leyton and Wanstead (Harry Cohen) are already in place. They are not and that bodes for total disaster.
I will not accept what is going on and I will do all I can to stop it. I will not allow my constituents to suffer as a result of these bureaucratic, account-driven, false and short-sighted plans. Given the population growth and impact in east London generally, this process cannot go ahead. Please stop it now, so that we can get proper planning of health provision throughout north-east London.
10.31 am
Tom Brake (Carshalton and Wallington) (LD): I start by congratulating the hon. Member for Leyton and Wanstead (Harry Cohen) on securing this critical debate. It is worth picking up on a couple of points he made. He set out clearly the level of deprivation in his area and its health needs, but also the progress that is being made by Whipps Cross. One issue that he and other hon. Members touched on was that of independent treatment centres and the impact of their guaranteed business, which ends up sucking business out of hospitals and threatening their viability.
We heard passionate contributions from the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) and from others. I was a bit worried that the hon. Member for Ilford, South (Mike Gapes) might need to make use of his hospital, because of the way he was going at the end of his contribution. What hon. Members have done is clearly demonstrate that this is not a party political matter, but a question of ensuring that the needs of the local community are met, and we support that notion.
The debate is not taking place in isolation from what is happening to the NHS nationally. It is worth reminding Members of a couple of points. The NHS, in spite of receiving significant, above-inflation increases, is in deficit. Many trusts are in deficit and although a few months ago the Department of Health was predicting it was going to be in surplus, it is now predicting an overall deficit. There have been in the order of 1,000 or more compulsory redundancies. The Royal College of Nursing’s estimate of the number of jobs lost is far greater: it is quoting a figure of 20,000, including voluntary redundancies, frozen posts and the cancellation of temporary contracts.
The issue of hospital reconfiguration is not only playing out in north-east London, but all over the country. The NHS chief executive announced back in September that there were going to be 60 reconfigurations, which would principally hit the accident and emergency departments, paediatric and maternity services. Hon. Members will be very familiar with the Institute for Public Policy Research report. The IPPR is a think tank that is often quoted by the Government, which has identified that there is an excess—to use its term—of 57 general hospitals in England, and eight too many in London, according to its figures. Those reconfigurations are often taking place without any regard to what is happening in the vicinity or other factors. The Olympics has been mentioned, but there is also the question of population growth, and that of the M11 corridor, in the vicinity of which 11,000 new units will be built. That will clearly have an impact on the Princess Alexandra hospital: the hospital that might have to pick up patients from Whipps Cross. Those factors do not seem to have been taken into account at all.
There is also the matter of the decline of productivity in the NHS. It is against that backdrop that decisions are being taken. The future of Whipps Cross and King George hospitals clearly commands all-party support. The right hon. Member for Chingford and Woodford Green and the hon. Member for Leyton and Wanstead have been prominent campaigners on the issue. I would also like to praise my colleagues on Waltham Forest council. The campaign there has been backed unanimously by councillors at an emergency meeting that was held in November, where a motion was proposed by John Beanse, who is the vice-chairman of the council’s health scrutiny committee. It was adopted by the council, and it called for a range of services currently available in the borough to be maintained. The council then referred the matter to the Secretary of State and I wish it good luck. I hope that it receives a positive response.
Such issues will be familiar to Members both inside and outside London. The situation described by the hon. Member for Leyton and Wanstead is almost a mirror image of the situation in south-west London. The Minister had to respond in a debate about that a week or so ago and he must now be feeling a sense of déjà vu about the issues raised. It was a lot easier for the Minister to respond in that debate by saying that it was simply a matter that Opposition Members were raising for the sake of opposition. Today, he has to address a more significant, all-party issue and will not simply be able to say that the matter has been raised only by Opposition Members.
The process of primary care trusts and acute trusts trying to address deficits is taking place without any democratic accountability, and other hon. Members have referred to that. Decisions are being taken in isolation and not only do they not want to promote democratic accountability and involvement, they want to discourage it, and they do not see a role for Members of Parliament to play in the process. It is the lack of democratic accountability that makes such decisions a lot harder. The primary care trusts and the acute trusts within the NHS in London are not seeking to engage the local community, so when they come up with proposals, they are shot down in flames because no one has been involved in the process or feels party to those decisions. When the local community has input through the overview and scrutiny committees, one sees more and more cases referred to the Secretary of State. However, I am afraid that often their views are not given any particular weight. As of a couple of months ago, only one referral made by an overview and scrutiny committee had been responded to positively by the Secretary of State.
We are not against changes in local services. We are against the way in which they are imposed on local people, without their having a genuine say in shaping things. Will the people of north-east London have a genuine say in what services are provided in their area? Will the consultation be meaningful? I very much doubt it. We believe in greater local democratic accountability. Consultation with local people and clinicians must directly influence local health services and do so at an early stage of the process. That will give local people real ownership of their local health service, while allowing health experts to make difficult decisions on health care delivery.
The Government promised freedom and innovation controlled by local people, but in reality, hospitals are being kept on a short leash and local people have little or no say in how their local trusts are run. It is time to introduce more accountability into the service. Local councils should play a greater role in health so that people can hold them to account for what is happening to local NHS services. We want greater freedom for NHS hospitals through local democratic involvement in the buying and planning of health services. Above all, our local hospitals should have their roots in local communities. That is what the people of north-east London want: they should not be denied that right.
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